ABSTRACT
Atrial fibrillation (AF) can be managed by either a rate-control or a rhythmcontrol strategy. For patients at risk for stroke, anticoagulation with warfarin is clearly indicated. The rationale for using a rate-control strategy as first-line therapy has been confirmed by the concordant results of the Pharmacologic Intervention in Atrial Fibrillation (PIAF) trial (1), the Strategies of Treatment of Atrial Fibrillation (STAF) trial (2), the Rate Control versus Electrical Cardioversion (RACE) trial (3), and the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) trial (4). For patients with minimal or asymptomatic atrial fibrillation, a rate-control strategy is eminently reasonable.
